In an international study in The Lancet, Dr. Annette Regan and colleagues studied birth records from three wealthy countries over a more than 35-year period to determine if shorter interpregnancy intervals after a stillbirth affected the likelihood of adverse outcomes. Findings that shorter interpregnancy intervals after stillbirth do not increase risks of adverse events in subsequent pregnancies could help develop guidelines to go along with existing advice regarding family planning after live births and miscarriages.
Researchers used records of births between 1980-2016 from Finland, Norway & Australia. They restricted their analysis to avoid multiple births and pregnancies lasting less than 22 weeks as well as records missing data on gestational age, birthweight and other factors. They used records from women who had previously had a stillbirth and calculated how much time had passed between that stillbirth and the next pregnancy. They then compared the risk of stillbirth, preterm birth and small-for-gestational-age in their next pregnancy, by interval.
They found a median interpregnancy interval of nine months after stillbirth, which differs from the median 25 months they noted following live births. More than 60 percent of women conceived within 12 months after a stillbirth. To avoid mediating effects and confounding variables, they adjusted their analyses using data on maternal age, gestational age of the previous pregnancy and decade of births and conducted additional analyses to measure effects of maternal education and smoking. Both adjusted and unadjusted analyses found no association between interpregnancy intervals of twelve months or less and stillbirth, preterm birth, or small-for-gestational age, suggesting conception quickly after a stillbirth may be safe.Tags: Friday Letter Submission